Hospitals present one of the most demanding operating environments for physical security systems. They must remain open and accessible while managing emotionally charged situations, chronic staffing shortages, and a documented rise in workplace violence.
For security integrators, this combination creates both a responsibility and an opportunity: hospitals need solutions that reduce risk without adding friction or overburdening staff.
Many healthcare organizations still rely on paper-based BOLO (be on the lookout) lists, static photo binders or informal word-of-mouth processes to identify known threats or repeat offenders. These approaches were not designed for modern hospital traffic volumes or staffing realities.
For integrators designing front-door security architectures today, BOLO and person of interest (POI) capabilities have become a critical system layer, not a nice-to-have feature.
Paper-Based BOLO Programs Fail at Scale
Traditional BOLO programs depend on printed materials and human memory. In high-throughput areas such as emergency departments, maternity wards and behavioral health units, these systems break down quickly. Guards rotate shifts often and staff turnover is high. It’s impossible for staff to remember every person of interest by memory.
According to the U.S. Bureau of Labor Statistics, workplace violence in healthcare settings is roughly five times higher than in other industries. That statistic alone underscores the operational risk hospitals face when identifying a high-risk individual depends on recall instead of identification depends on recall alone.
For integrators, this presents a clear security gap for most hospital settings. When threat identification relies on manual processes, no amount of camera coverage or access hardware can compensate for missed recognition at the point of entry.
Real-Time Identification Is the Differentiator
Effective BOLO systems must operate in real time. Documenting an incident after the fact does nothing to prevent escalation. It’s important that modern systems integrate directly into the hospital’s visitor management platform and credentialing workflows, using ID scanning to automatically flag individuals the moment they try to enter a facility.
Artificial intelligence-enabled technology allows the video monitoring system (VMS) to instantly match internal BOLO lists and approved external data sources without slowing visitor flow. For integrators, this capability shifts security design from reactive reporting to proactive intervention.
The system identifies risk before an incident unfolds, giving on-site teams the opportunity to act early and appropriately.
A peer-reviewed study in the Journal of Nursing Management found that hospital violence is frequently underreported due to time-consuming manual reporting processes. Automation reduces this friction while improving consistency and data integrity. From an integration standpoint, this means better inputs, cleaner logs and more reliable downstream reporting.
Simplifying Operations, Not Adding Complexity
There is a misconception that AI-powered security systems make things more complicated, but well-designed BOLO platforms do the opposite. Such systems actually eliminate the need for constant visual cross-checking and the updating of lists manually. In addition, when a POI or BOLO is detected, alerts can be sent in real time.
Compliance, Documentation and Audit Readiness
Increasingly, healthcare security programs are under pressure to maintain accurate records of those entering their facilities. An advanced BOLO and POI system helps the hospital remain in alignment with the U.S. Department of Homeland Security Best Practice 15.4.5, which recommends credentialing programs to manage building access and maintain reliable records of authorized individuals.
Replacing manual data entry with ID scanning reduces human error and produces standardized, auditable records without increasing administrative workload. For integrators, this strengthens the compliance narrative and simplifies system justification during procurement and review cycles.
Reliability In Real-World Conditions
Hospitals cannot afford security blind spots during outages or emergencies. Some BOLO platforms have the ability to remain online even when systems are offline–ensuring identification and alerting continue even during temporary network disruptions.
According to the Centers for Disease Control and Prevention, workplace violence accounts for approximately 75 percent of all workplace assaults with healthcare settings among the most affected. Systems must perform under stress, not just under ideal conditions. Reliability is not optional.
What This Means for Security Integrators
Paper-based BOLO lists were not designed for today’s threats. Healthcare organizations are increasingly aware of this gap, and they are looking to integrators to identify solutions that can close it without disrupting care.
The reality is BOLO and person of interest capabilities have evolved into a fundamental component of modern hospital security architecture. Such technology simplifies execution, strengthens documentation and provides real-time situational awareness at the front door, where risk often begins.
Integrators who understand and deploy these systems are not just installing new technology. They are helping healthcare clients close one of the most persistent and gaps in facility security.
Christopher Ciabarra is the co-founder and chief technology officer of Athena Security.
